Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 2

Upper Extremity Complications After Stroke

Kaan Uzunca 1
1 Trakya Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Edirne

After stroke, prognosis of upper extremity is generally poorer than that of lower extremity because the upper extremity functions are more complex than lower extremity. Moreover comorbid conditions and additional upper extremity complications also influence the prognosis negatively. The incidence of hemiplegic shoulder pain changes in the range of 38-84%. It is related with worse functional improvement and long hospital stay. The pain can be related with joints, periarticular tissues and neural structures. The main causes of hemiplegic shoulder pain are glenohumeral subluxation, shoulder-hand syndrome, rotator cuff lesions, adhesive capsulitis, central thalamic pain, brachial plexus and peripheral nerve lesions. Heterotopic ossification and trombophlebitis are the other rarer upper extremity complications after stroke. Spasticity is another clinical picture observed and can lead to deformities and contractures. Spasticity can also cause painful syndromes by interrupting the normal joint kinematics. In this review, the mechanisms, clinical features, management strategies of the clinical conditions written above and their effects to the prognosis are detailed.  

Keywords : Stroke rehabilitation, upper extremity complications